Objective: To assess the clinical outcome and pharmacokinetics of ther
apy with cefazolin far patients with cellulitis in a hospital-ill-the-
home (HIH) program. Design: Observational study with outcome data comp
ared with previously published reports of therapy for cellulitis. Sett
ing: A university teaching hospital and HIH unit, July 1996 - December
1997. Participants: Patients with cellulitis were eligible for inclus
ion provided their medical condition was stable, they did not require
surgical intervention, and their social circumstances allowed home-bas
ed therapy. Intervention: Cefazolin 20 intravenously twice daily, with
regular nursing and medical assessment. Main outcome measures: Clinic
al efficacy; peak and trough serum concentrations of cefazolin. Result
s: Fifty-seven patients (37 were men) with a mean age of 48 years (ran
ge, 18-90 years) had 61 episodes of moderate to severe cellulitis (41,
lower limb; 17, upper limb; and three, face). They received a median
of 11 doses of cefazolin (range, 3-27 doses). Clinical outcomes were:
cure in 54, improvement in one, treatment failure in three, and in the
remaining three episodes the outcome was indeterminate. Cefazolin con
centrations were measured in 27 patients. All peak concentrations were
more than 40 mu g/mL, while trough concentrations were all above the
MIG(90) of the expected pathogens: median, 3.2 mu g/mL (range: 0.4-18.
5 mu g/mL). Cefazolin was well tolerated. Conclusions: Twice-daily cef
azolin 20 intravenously is a convenient and effective option for home-
based treatment of patients with cellulitis. Its clinical efficacy is
comparable with other treatment regimens.